Welcome to the Fall 2019 Back To School edition of Family Matters – Families Matter, authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.
Fall. Thoughts of crisp autumn nights and drinking apple cider come up for me, of my youth spent in the Midwest. It also reminds me of “back-to-school” time which can cause some concern for many parents, as well as their new students heading off to University. I’ve been working with a couple of sets of parents with college-aged kids who are all nervous that these young folks aren’t prepared for the new challenges, new people, and new temptations both healthy and less so. Perhaps there’s been problematic drug use or some other challenging behavior/mental health concern which is also interfering with their child’s ability to prepare better for these new experiences. So, what’s a family to do? While we might not be able to prepare our kids for every new experience, we can definitely work on listening better to what they say they need/want – and what they don’t want/need from us – which I think is at the core of improving all family relationships. Plus, these same communication skills will be used for the rest of all our lives: with our family members, friends, colleagues, everyone. And yet, these are skills that are rarely taught, which leaves us to learn them through trial and error or with the help of books, coaches, counselors, podcasts, and more. So, how can we learn to listen more and talk less, no matter what’s getting in the way?
While there is no magic answer to doing this, it really is the simple answer to better communication. And boy, it’s really easier said than done! With my own fractured family, I see just how hard this is to do. But there are ways we can get better. Here are a couple of ways to improve conversations within families and begin to get a bit better at “listening more and talking less,” especially with our adult kids using drugs problematically. The first, from the Australian online group Family Drug Support (FDS), founded by Tony Trimingham, (look for FSDP’s launch of our own FDS USA soon!) are these basic ideas: 1) Choose your moment – e.g. not when someone is under the influence of drink/drugs. This first step to better conversations is also discussed in many other books and trainings on Family Coaching including Robert Meyers’ Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening and The Parent’s 20 Minute Guide1.
Another strategy I have adopted from The Parent’s 20 Minute Guide is to think of conversations as if there are traffic lights in a thought bubble above the other person(s) head. For example, a green light means someone is engaged and listening (though perhaps not about the subject you’d like to discuss!); a yellow/caution light means we may be headed into dangerous territory (think “danger, danger Will Robinson”, to borrow a phrase): actions such as voices starting to be raised or someone changing subjects defensively; and a red light means the conversation has gone off into unwanted topics, leaving our loved one and/or us threatening, screaming, swearing, or falling silent and retreating. Not a lot of listening going on when we see these behaviors so experts suggest we stop trying to have a conversation then and simply step away. Remember, these “lights” refer to all family members not just the person(s) using drugs problematically. That’s really important. In fact, one of the parents I work with calls these “caution” signs “relapse warning signs for the whole family.” Here’s an example of how a conversation might look using all the lights:
Beginning statement from you: “I’m really concerned about your grades this semester.”
Your child: “OK I know I’ve slipped a bit but can we discuss this later please?”
Your response: “OK I understand this isn’t a good time. When can we talk about this please?” (green)
Your child: “Stop interfering in my life! I’m an adult now and you can’t tell me what to do!!”
Your response: “You’re right you are an adult. We’re just concerned and want to help if we can.” (red)
Your child (voice raising): “I know, I know! But I’ve had a lot of hard classes and it’s been a lot more work than I thought! Can’t you just get off my back?”
Your response: “You sound pretty stressed out right now. Let’s talk about this over the weekend when we’re both calmer.” (yellow/caution)
Another strategy toward better listening – or what clients sometimes call “not taking the bait” in conversations – comes from Motivational Interviewing or MI. In MI, there’s a strategy we teach called “key questions” which I think are brilliant. These are statements I make when it either feels like I’m wanting to take charge of a situation or it seems that someone expects me to have answers for them. These are a way to respond that shows my interest in the conversation while not taking the bait of thinking I need to come up with answers/take charge. Here’s an example:
You: “I’m really concerned about your grades this semester.”
Your child: “Well what am I supposed to do? It’s really stressful…and these classes are much harder than in high school!”
Your response: “Things are definitely harder than you expected (this is called a reflection). What do you think would be helpful to make things easier right now (key question)?”
See how this parent has let go and not taken the bait? Instead of saying something like, “well you know what you need to do is…” and trying to solve this problem for them – in MI we call this “the expert trap,” which means we’re assuming we HAVE the right answers for someone else, like we’re experts in other people’s lives which of course we’re not – this parent gives the solution back to their child. This also helps the child learn to figure out what’s best for them and not to rely on us parents. By the way, this doesn’t mean we can’t ever offer advice or have an idea. But again, borrowing from MI, when we do so, the third tip for better conversations is to ask for permission before offering any ideas. Yes, you heard me: ASK FOR PERMISSION. It’s simple thing to do and it shows respect to the other person.2
Along these same lines, something I learned to use with my now adult son while he was in college was to ask at the beginning of a call, “do you want me to listen with the goal of giving advice or with the goal of just listening?” That simple phrase helped me a lot. It was important for me to set that goal up front and it also seemed to help my son communicate to me more fully and honestly. Of course, the REAL trick is to keep quiet when you hear things that make you want to scream, “NOOOO!!!” But I learned that my son – like most of our kids – was pretty darned good at making generally healthy decisions for himself – and the couple of times that he wanted advice, he was able to ask for that since I’d respected his desire and not given unwanted advice the other times he called. Come to think of it, he might’ve even called home a bit more than he would have.
The more we understand that much (most?) of someone’s drug use is a direct result of medicating trauma, anxiety, depression and more, the more we also see that improving conversations with our loved ones is crucial to keeping our families listening and attached rather than talking at each other and detached. And that’s always the goal, huh?
Navigating conversations in families is always challenging let alone when someone is using drugs problematically! I get it. And I can definitely say that this way of deeply listening to each other takes work, commitment, and practice. And a willingness to make a lot of mistakes. To help reduce mistakes, one of the parents I work with likes to make “flashcards” of bytes of responses they could make when their adult child begins to unravel or becomes demanding (and old pattern of push/pull that they’ve all become expert on). I am immensely impressed with these families and their collective loved ones for their efforts to change these imbedded patterns!
Being a part of a family takes real effort, like all relationships, with more listening than talking at the core. Dr. William Miller, who co-wrote the book Motivational Interviewing, has a new book out called Listening Well: The Art of Empathetic Understanding that I often use with families if they’re interested. It’s an easy read, less than 100 pages, with exercises at the end of most chapters (some of which are three pages long) that can be done in session with a professional as well as at home for practice. In it, Dr. Miller discusses the idea that one of the main ingredients to “listening well” is to have compassion and empathy toward one another: this means all family members, drug users and non-drug users alike. To me this concept is also at the core of an idea that I first learned from an early mentor of mine, Jane Peller, LCSW, co-author of Recreating Brief Therapy and retired professor of Social Work, Northeastern University: think of this as “Appreciation.” Jane taught me that if I were to be successful with a client, I needed to find something to appreciate in each of them – and if I can’t then I need to refer them on to someone else who might be able to help. Well, I say if we’re going to be successful in conversation with someone using substances, we need to appreciate what those substances are doing for that loved one that nothing else seems to help. I also need to find something in my loved one to appreciate about them as they are today, not as I remember them or wish they were (again this applies to all members of the family). I even go so far as to explain to everyone I work with that someone’s drug use (or other problematic behaviors) makes perfect sense if we understand that drug use is a symptom of something and not a pathology. After all, all behaviors provide us with some reward – or we’d stop engaging in them (even if the reward is negative by the way).
This is where listening deeply comes into play. We need to be able to hear – and possibly without words – the reasons that our loved ones are using drugs or are engaged in other less healthy behaviors. To those using drugs problematically I will often say that they too need to find a way to appreciate the drugs they’ve been using (I realize that may sound strange but hang with me). Why? Because it’s likely that those drugs kept them alive to get to this place – of considering change. And then I typically follow up that remark with, “And isn’t it interesting that the very behavior that helped you cope/stay alive is now killing you/putting the things and people you love at risk?” Finally, I’ll ask something like this (here comes the key question): “So, what do you think you’d like to do now?” This is what I like to call an INVITATION to make a change – or to think about making a change or consider what would need to happen to be ready to consider a change, or anything that speaks to talking about any positive change.
Please don’t hear that I’m suggesting for one minute that you must agree with or like your loved one’s drug use or any other behaviors (nor do they need to like yours). Not at all. In fact, that’s the “trick”: “How do I appreciate/try to understand this thing you’re doing/using that may be helpful & deadly to you and that I really hate because it may kill you?” Well, I’d argue that this is our job as family, as loved ones, and definitely as parents: we recognize that your behavior shows just how much pain our family and our beloved family member is in.3
Gabor Mate and others in the trauma world have spoken about the rates of trauma in folks with problematic drug use/other coping behaviors; for women, it’s up to 99% of those seeking treatment for substances (Najavits, 2002)! Trauma is a main factor in drug use because of the fact that so many drugs work well to alleviate the anxiety, fear, and uncomfortable, overwhelming feelings that often arise with trauma (as someone with a diagnosis of non-combat PTSD, I can attest to how well various illicit and licit drugs can work – and how they can become problematic without treatment to address the trauma): “Up to 59% of young people with PTSD subsequently develop substance abuse problems. This seems to be an especially strong relationship in girls,” according to recent information from our National Institute of Health or NIH. But let me be clear here: not all trauma rises to the level of PTSD. Nor does all problematic drug use stem from trauma. However, the rates of trauma symptoms are increasing along with the rates of anxiety in teens of today causing some to see anxiety and trauma as the next health crisis in the making.
At the end of the day, only you and your family can decide what’s important to you all, what values you hold as a family, and how you’re going to respond to a loved one’s substance use, problematic or otherwise. Whatever you decide, I invite you to consider that as your child moves into adulthood and leaves home, it may be time to reevaluate your relationship with them and make a goal to HAVE a longlasting relationship with your child no matter what they do/decisions they make. To lose your family support is about the most damaging thing we know of when looking at any number of health-related problems. We also know that family support is a major reason for successful treatment for substance use disorders, and that being connected is the best way to support mental illness as well.4
While we may not be pleased with all the decisions our children make – nor they of all of ours – perhaps we could all do a bit better to act with compassion, empathy, and most of all, with unconditional LOVE toward each other. I know that I would never have made the Herculean effort to change my own drug-related behaviors/improved my mental health if it weren’t for the love of my son and my former husband. I certainly had no self-compassion and therefore no reason to stop – and my family of origin had mostly written me off. It’s been a lot of hard work – the same hard work I am honored to witness in the families and individuals I work with today. And while drugs hold little interest for me anymore, it doesn’t mean I have a life of ease or that my relationship with my adult son perfect. But I don’t look for perfection anymore – not in me and never in my clients. After all we’re human and therefore we will screw up. Doing better is good enough for me now. I hope it can be for you, too.
Dee-Dee Stout, MA
Author, Coming to Harm Reduction Kicking and Screaming
All photos courtesy of unsplash.com
1By the Center for Motivation and Change, 2nd edition (2016).
2These are all conversational suggestions. There are a LOT of ways to have better conversations and plenty of materials out there to help us. I have listed only a few here. -D.S.
3Paraphrased from Gabor Mate’s conversation with the author Chris Grosso in Dead Set on Living (2018), Gallery Books.